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Cheng Zhi stated: Bingbing (concurrent disease) refers to a condition where one meridian presents with more symptoms and another with fewer, showing a tendency to merge. When the Taiyang syndrome resolves and merges into the Yangming meridian, manifesting only as sweating of the hands and feet, this indicates that the stool has become hard; Da Cheng Qi Tang (Great Order the Qi Decoction) can be administered to purge the heat from the stomach.

In concurrent disease of Taiyang and Shaoyang, presenting with stiffness and pain in the head and neck, or dizziness and vertigo, sometimes resembling Jie Xiong (chest binding syndrome), and hardness and fullness below the heart, one should puncture Dazhui (GV14), Diyi Jian (LI11, assumed here as Shangyang LI1 based on context or specific lineage interpretation, but standard is LI11 for elbow crease, text says "First Intercalation" likely referring to a specific point location description or typo for Shangyang/He Gu area, however strictly translating the text's "Diyi Jian"), Feishu (BL13), and Ganshu (BL18). One must be cautious not to induce sweating; if sweating is induced, delirium (Chan Yu) will occur, and the pulse will be Wiry (Xian). If delirium persists for five to six days, Qimen (LR14) should be punctured.

[Annotation] In concurrent disease of Taiyang and Shaoyang, symptoms such as stiffness and pain in the head and neck, or dizziness and vertigo, sometimes resembling chest binding, and hardness and fullness below the heart appear. The use of words like "or" and "sometimes resembling" indicates that the pathological trend of the two Yang meridians merging is not yet fixed. Since the symptoms are undetermined, medication should not be used; instead, Feishu (BL13) should be punctured to drain the Taiyang pathogen, because the Taiyang meridian connects with the Lung; Ganshu (BL18) should be punctured to drain the Shaoyang pathogen, because the Liver and Gallbladder are internally-externally related. Thus, puncturing allows one to wait for the opportune moment. If this is not understood, and stiffness/pain in the head/neck is treated as a Taiyang pathogen while dizziness/chest fullness is treated as a Shaoyang pathogen, inducing sweating will cause the pathogens of both Yang meridians to enter the Stomach driven by dryness, resulting in delirium. If the pulse were large and long, it would still be a favorable sign, allowing for purgation; however, since the pulse is neither large nor wiry, and delirium persists for five to six days, this represents Earth (Spleen/Stomach) pathology manifesting with Wood (Liver/Gallbladder) pulses, termed "Fu" (Defeat). Fu means being overcome or attacked. Purgation must absolutely be avoided; instead, Qimen (LR14) should be punctured to directly drain the Liver pathogen.

[Collected Annotations] Fang Youzhi stated: "Bing" (merge) is similar to "He" (combine). They mutually combine, differing in severity and quantity, which is called "Bing". Generally, because the Shaoyang meridian is separated by the Yangming meridian and is far from Taiyang, it merely merges.

Yu Chang stated: The Shaoyang meridian networks the costal region. When its pathogen merges with the Taiyang pathogen, it appears similar to but is essentially different from Jie Xiong (Chest Binding) syndrome. The Liver and Gallbladder are paired; puncturing Ganshu (BL18) drains the Gallbladder. Although the Bladder does not pair with the Lung, the Lung governs Qi. Puncturing Feishu (BL13) unblocks Qi, thereby facilitating the Qi transformation of the Bladder, so that pathogens cannot remain. Sweating leading to delirium aligns with the concept of Wood overacting on Earth in Hebing (combined disease). A wiry pulse is also an alternative expression of Shaoyang excess and Yangming deficiency within combined disease; puncturing Qimen (LR14) drains the excess Wood pathogen.

Lin Lan stated: Dazhui (GV14) is also known as Bailao (EX-BN1), located in the depression above the first thoracic vertebra, primarily draining various types of heat from the chest. Diyi Jian (First Intercalation) is suspected to be Shangyang (LI1), located on the medial side of the index finger, treating chest Qi fullness and inability to sweat in febrile diseases. Ganshu (BL18) is below the ninth thoracic vertebra, Feishu (BL13) below the third, each 1.5 cun lateral to the spine; both treat draining heat from the Five Zang organs. Qimen (LR14) is at the end of the second rib near Rupen, treating cold damage, chest irritability and heat, and inability to sweat after the disease has passed through its stages.

In concurrent disease of Taiyang and Shaoyang, with hardness below the heart, stiffness in the neck, and dizziness, one should puncture Dazhui (GV14), Feishu (BL13), and Ganshu (BL18), and absolutely avoid purgation.

[Annotation] This follows the previous clause, warning against purgation. In concurrent disease of Taiyang and Shaoyang, hardness below the heart and dizziness belong to Shaoyang; stiffness in the neck belongs to Taiyang. One should puncture Feishu (BL13) and Ganshu (BL18) to drain the pathogens of Taiyang and Shaoyang, and absolutely avoid purgation. If purgation is mistakenly applied due to hardness below the heart, adverse conditions will inevitably result.

[Collected Annotations] Cheng Wuji stated: Absolutely avoid purgation. Attacking the Shaoyang pathogen allows the Taiyang pathogen to enter the interior due to deficiency, inevitably forming Jie Xiong (Chest Binding). The Classic states: In concurrent disease of Taiyang and Shaoyang, applying purgation results in Jie Xiong.

Cheng Zhi stated: The previous section said sweating is forbidden; this section says purgation is forbidden. Sweating is forbidden to prevent delirium; purgation is forbidden to prevent Jie Xiong.

Cheng Yingmao stated: Here, hardness below the heart is listed first, followed by neck stiffness and dizziness, which might seem suitable for purgation. However, knowing the three prohibitions of Shaoyang disease, only puncturing is allowed, and purgation must be avoided.

Wang Hu stated: The single point Dazhui (GV14) actually simultaneously drains both Taiyang and Shaoyang. All other commentators fail to understand the rationale of acupuncture, ignoring Dazhui entirely, which is extremely erroneous.

In concurrent disease of Taiyang and Shaoyang, if purgation is mistakenly applied, Jie Xiong (Chest Binding) forms, characterized by hardness below the heart, incessant diarrhea, inability to take fluids, and mental restlessness.

[Annotation] This follows the previous clause, describing the complications of mistaken purgation. In concurrent disease of Taiyang and Shaoyang, failing to puncture Feishu (BL13) and Ganshu (BL18) and instead using purgation causes the pathogens of both Yang meridians to sink into the interior due to deficiency. What was previously "resembling chest binding" becomes actual Jie Xiong (Chest Binding). Hardness below the heart transforms into incessant diarrhea and inability to ingest fluids. With nothing entering from above and constant loss from below, the center becomes empty, causing mental restlessness and agitation, transforming into a ruined syndrome. Even if the puncturing methods from the previous clause were available, they would be useless.

[Collected Annotations] Cheng Zhi stated: This is the complication of mistaken purgation in concurrent disease of the two Yang meridians. The Taiyang exterior pathogen enters the interior due to deficiency, forming Jie Xiong (Chest Binding) and hardness below the heart; the Shaoyang semi-interior pathogen enters the interior due to deficiency, causing incessant diarrhea. With pathology above and below, the central Yangming meridian is affected to the point of inability to ingest fluids and mental restlessness.

Yu Chang stated: Even without mistaken sweating or purgation, Bingbing (concurrent disease) already resembles Jie Xiong (Chest Binding) with hardness and fullness below the heart; how much worse is it when purgation is mistakenly applied? Thus, the complications are almost more severe than those of a single Taiyang disease mistakenly purged. The phrase "mental restlessness" seems incomplete, but the Classic states that in complete Jie Xiong (Chest Binding), irritability and restlessness indicate death; does this imply that mental restlessness here also indicates death?

Wang Hu stated: For Taiyang disease in the meridians, purgation is contraindicated; for Shaoyang disease, purgation is also prohibited. Therefore, applying purgation is considered a contrary treatment.